Free USMLE-STEP-3 Web TestEngine Demo

Q90 Single choice

A55-year-old man with hepatic cirrhosis from alcohol abuse presents with a massive hematemesis. This is his third admission for upper GI hemorrhage in the past 2 months. He is currently receiving appropriate therapy for liver failure, including a beta-blocker and diuretics. He is lethargic and confused. His pulse is 100 and blood pressure is 85/40. His initial hematocrit is 20.
After fluid resuscitation, which of the following is the most appropriate management strategy?

A
The transplant team should be called immediately.
B
The bleeding is probably secondary to an uncontrolled duodenal ulcer related to his alcohol use.
C
Red blood cells should be administered immediately, but fresh frozen plasma should be withheld if possible.
D
Endoscopic control options include sclerotherapy and banding.
E
Transjugular intrahepatic portal systemic shunt (TIPS) is not an option in the immediate period.

USMLE-STEP-3 Web TestEngine demo